| 24h尿蛋白定量与重度子痫前期母婴并发症关系研究 |
| 投稿时间：2017-04-07 修订日期：2017-05-11 点此下载全文 |
| 引用本文：伍绍文,张为远,汤丽荣.24h尿蛋白定量与重度子痫前期母婴并发症关系研究[J].医学研究杂志,2018,47(2):83-86 |
| DOI：
10.11969/j.issn.1673-548X.2018.02.020 |
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| 基金项目:北京市优秀人才基金资助项目（2015000021469G214）；北京市医院管理局"青苗"计划基金资助项目（QML20161401）；首都医科大学附属北京妇产医院中青年学科骨干培养专项基金资助项目（fcyy201414） |
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| 中文摘要:目的 探讨24h尿蛋白定量与重度子痫前期的母婴并发症关系。方法 选取2011年1月1日~12月31日中国大陆地区共37家医院，其中18家三甲医院及19家二级医院所有诊断为重度子痫前期且发病孕周在28周以上的单胎孕妇共2305例。根据入院后最高24h尿蛋白定量结果分为3组：Ⅰ组尿蛋白定量为0~2g，共590例，Ⅱ组尿蛋白定量2~5g，共843例，Ⅲ组为5g以上，共872例。分析不同组别的母儿并发症的发生率。结果 研究对象中低蛋白血症的发生率为14.8%，胸/腹腔积液/肺水肿/心力衰竭的发生率为1.6%，肾功能损害的发生率为0.6%，胎盘早剥的发生率为2.7%，HELLP综合征发生率为3.0%。各组间低蛋白血症的发生率差异有统计学意义，Ⅰ组的发生率明显低于Ⅱ组及Ⅲ组（P<0.017）。胎儿生长受限的发生率为3.3%，胎儿窘迫的发生率为9.5%，新生儿窒息的发生率为1.1%。三组新生儿体重、胎儿生长受限及新生儿窒息的发生率差异有统计学意义（P均<0.05），Ⅰ组新生儿体重明显高于Ⅱ组及Ⅲ组（P<0.017）。Ⅱ组FGR的发生率明显高于Ⅲ组（P<0.017）。Ⅰ组的新生儿窒息发生率明显低于Ⅲ组（P<0.017）。三组间心力衰竭/肺水肿、胎盘早剥、HELLP综合征及剖宫产率差异无统计学意义。结论 不同程度的24h尿蛋白可能增加了重度子痫前期孕妇低蛋白血症的风险，但不增加心力衰竭/肺水肿、胎盘早剥及HELLP综合征的风险。24h尿蛋白定量与重度子痫前期新生儿体重、胎儿生长受限及新生儿窒息的发生率相关。 |
| 中文关键词:24h尿蛋白定量 重度子痫前期 母儿并发症 |
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| Study on the Relationship between 24-hour Urinary Protein Quantification and Maternal and Neonatal Complications in Severe Preeclampsia |
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| Abstract:Objective To investigate the relationship between 24-hour urinary protein quantification and maternal and neonatal complications in severe preeclampsia.Methods Totally 2305 cases of pregnant women which were diagnosed as severe preeclampsia more than 28 weeks of single pregnancy in 37 hospitals in mainland China were selected from January 1 to December 31, 2011. According to the results of the highest 24 hours urine protein quantitative after admission, the subjects were divided into 3 groups. The group Ⅰ included 590 cases whose 24h urinary protein were 0-2g. There were 843 cases in group Ⅱ whose 24h urinary protein were 2-5g, 872 cases were in group Ⅲ whose 24h urinary protein were more than 5g. The complications of the maternal and neonatal outcome were analyzed among the three groups.Results The incidence of hypoalbuminemia was 14.8%, the rate of chest/ascites/pulmonary edema/heart failure was 1.6%, the incidence of renal dysfuction was 0.6% and the incidence of placental abruption and HELLP syndrome was 2.7% and 3.0%. There was significant difference in the incidence of hypoalbuminemia among the three groups of which the incidence of groupⅠwas significantly lower than that of group Ⅱ and group Ⅲ (P<0.017).The rate of fetal growth restriction, fetal distress and neonatal asphyxia was 3.3%, 9.5%, and 1.1%. The incidence of neonatal body weight, fetal growth restriction and neonatal asphyxia among the three groups were significantly different (P<0.05). The body weight of neonatal group was significantly higher than that of group Ⅱ and group Ⅲ (P<0.017). The incidence of FGR in group Ⅱ was significantly higher than that in group Ⅲ (P<0.017). The rate of neonatal asphyxia in group Ⅰ was significantly lower than that in group Ⅲ (P<0.017). There are no significant difference in the incidence of heart failure/pulmonary edema,placental abruption,HELLP syndrome and cesarean section among the three groups.Conclusion 24-hour urinary protein may increase the risk of hypoalbuminemia in pregnant women with severe preeclampsia, but do not increase the risk of heart failure/pulmonary edema, placental abruption and HELLP syndrome. 24-hour urinary protein was associated with severe preeclampsia neonatal body weight, fetal growth restriction, and neonatal asphyxia. |
| keywords:24-hour urinary protein quantitative severe preeclampsia maternal and fetal complications |
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